1. Cardiac Arrest Record Fiona Barton Senior Resuscitation Officer
University Hospital Kerry
IARO 7th April 2017
Mullingar

2. Why? Collection of Utstein data
Guidance for Resuscitation Team during and after an event
Accurate patient notes

3. Patient records
Audit unveiled many cases of inaccurate or incomplete recording of event by different healthcare professionals.
‘Move patient to ICU for ventilation and post ROSC care’
Medical Reg
‘Keep in medical ward on CPAP’ Anaesthetic Reg
‘PEA shocked x2’ Medical SHO
‘VF shocked x1 ED RGN

4. Patient records Time not recorded at all or using 12 hour clock.
Impossible to tell who had actually attended the event.
Lots of recording of ‘resuscitation attempted as per ACLS guidelines’.
Route of drug administration not easy to identify.
Inconsistent post ROSC orders.

5. Utstein data
Updated in 2015

6. Guidance for team
Aid memoire for staff working in high pressure situation.
Peri arrest guidance
Hs and Ts memoire
Ease of recording for time keeper
Checklist for post ROSC care
Aids team debrief

7. Situational Awareness is…
the ability to identify, process, and comprehend the critical elements of information about what is happening to the team with regards to the mission. More simply, it's knowing what is going on around you.
US Coastguard

8. Team Debrief
A brief review with the goal of reflecting both negative and positive events whilst still vivid in the mind of team members, and to identify and promptly address issues regarding equipment or processes.

9. Why debrief? Effective communication tool Ongoing process improvement
Reduction of provider stress and burnout.

10. How? Make it part of EVERY 2222 call
Time limit to between minutes
Find a suitable corner
Record result. Action what can be actioned. Escalate what needs to be escalated.

11. Post Event Debrief
Pre-Alert Information: (Correct call for correct team to correct location)
Initial team Organisation: ( Well organised, Team leader, Clear Team & Role allocation)
Main Event: ( Correct guidelines, Situational awareness, Team dynamics, Close Loop Communication)
Event Completion/ Outcome: (Agreement to stop CPR, Correct management of ROSC)
Post Event Administration: (Completion of paperwork, Tidy up and prepare, Thank everyone involved)

12. Post ROSC Care